Presence of temporomandibular joint discomfort related to pacifier use

Aim: The goal of the present study was to analyze if the duration of pacifier use influenced the stomatognathic system in children that did not present any other parafunctional habits. Study design: Transversal cohort study. Material and Method: To collect data, a questionnaire was used and answered by the mothers of 90 children aged three to seven years old. Results: The children were divided into three groups: did not use pacifier; used pacifier until 2 years old; and used pacifier for more than 2 years. Greater prevalence of pain or discomfort in the stomatognathic system was observed among the children who had not used pacifier and the children who had used it for more than 2 years. The prevalence was smaller among the children who used pacifier until 2 years of age. Conclusion: Thus, it is concluded that pacifier is important to induce children to perform suction movements, preparing them to the introduction of solid foods. However, if used for a prolonged period of time, it may damage the joint and consequently the child's quality of life.

Pacifier Sucking in a Child with Cleft Palate: Occlusal Consequences

Objective

The case of a child with a repaired cleft palate and a pacifier habit is presented. The influence of both the cleft and the habit on the malocclusion is discussed. The malocclusion disappeared as the habit ceased.

Relationship between oral parafunctional/nutritive sucking habits and temporomandibular joint dysfunction in primary dentition

The aim of this study was to evaluate the relationship between nutritive and parafunctional habits and the presence of temporomandibular dysfunction (TMD) in children with primary dentition.

METHODS

Ninety nine children, aged 3-5 years, were examined to check for the presence or absence of signs and symptoms of TMD (headache, preauricular pain, earache, masticatory muscle tenderness, deviation on opening, occlusal interference and asymmetric movement of the mandible), oral parafunctions (bruxism, nail biting, finger/thumb sucking, speech alteration, mouth breathing, pacifier and atypical swallowing) and nutritive habits (breast- or bottle-feeding) through interview and clinical examination. The results were submitted to descriptive statistical analysis and Fisher's exact test.

RESULTS

The results showed that only atypical swallowing was positively related to TMD (P < 0.0001); other oral parafunctional and nutritive habits were not related to TMD.

CONCLUSIONS

It was concluded that parafunctional habits, with the exception of atypical swallowing, and feeding methods were not determinants for the presence of signs and/or symptoms of TMD in the sample of children included in the study.

Feeding, artificial sucking habits, and malocclusions in 3-year-old girls in different regions of the world

PURPOSE

The way babies and young children are reared is important to their health and development. Extensive breast-feeding has also been shown to reduce the development of artificial sucking habits like digit or pacifier-sucking. The aim of this study was to determine feeding methods, artificial sucking habits, and the presence of malocclusions in 3-year-old girls living in different regions of the world.

METHODS

Children from the following countries were involved in the present study: (1) Brazil (Porto Alegre); (2) Japan (Niigata); (3) Mexico (Mexico City); (4) Norway (Oslo); (5) Sweden (Falköping); (6) Turkey (Istanbul); (7) and the United States (Iowa City, Iowa). During the interview and examination, the following variables were evaluated and registered: (1) breastfeeding and bottle-feeding; (2) duration and frequency; (3) sucking habits; (4) posterior and anterior crossbites; and (5) other malocclusions/normal occlusion.

RESULTS

The prevalence of breast-feeding was very high in all groups, ranging between 78% and 98%. The prevalence of bottle-feeding in the different areas was also high. Except for Iowa City, the prevalence of digit-sucking was relatively low. Pacifier-sucking is fairly popular in most areas, with the exception of Niigata. The prevalence of normal occlusion in different cities ranged from 38% to 98%.

CONCLUSIONS

There are considerable differences in feeding, as well as artificial sucking habits, in different areas of the world and at different periods.

Breast feeding, bottle feeding, and non-nutritive sucking; effects on occlusion in deciduous dentition

AIMS

To assess the effect of the type of feeding and non-nutritive sucking activity on occlusion in deciduous dentition.

METHODS

Retrospective study of 1130 preschool children (3-5 years of age) who had detailed infant feeding and non-nutritive sucking activity history collected by a structured questionnaire. They all had an oral examination by a dentist, blinded to different variables evaluated.

RESULTS

Non-nutritive sucking activity has a substantial effect on altered occlusion, while the effect of bottle feeding is less marked. The type of feeding did not have an effect on open bite, which was associated (89% of children with open bite) with non-nutritive sucking. Posterior cross-bite was more frequent in bottle fed children and in those with non-nutritive sucking activity. The percentage of cross-bite was lower in breast fed children with non-nutritive sucking activity (5%) than in bottle fed children with non-nutritive sucking activity (13%).

CONCLUSIONS

Data show that non-nutritive sucking activity rather than the type of feeding in the first months of life is the main risk factor for development of altered occlusion and open bite in deciduous dentition. Children with non-nutritive sucking activity and being bottle fed had more than double the risk of posterior cross-bite. Breast feeding seems to have a protective effect on development of posterior cross-bite in deciduous dentition.

[Common problems during lactation and their management]

OBJECTIVE

To present an updated review on common problems associated with breastfeeding and their management.

SOURCE OF DATA

A comprehensive bibliographic review on the issue was performed by searching publications from the MEDLINE database and from national and international organizations. Books and some key articles cited in other sources were also selected.

SUMMARY OF THE FINDINGS

Several common problems that may arise during the breastfeeding period, such as breast engorgement, plugged milk duct, breast infection and insufficient milk supply, originate from conditions that lead the mother to inadequate empty the breasts. Incorrect techniques, not frequent breastfeeding and breastfeeding on scheduled times, pacifiers and food suppliers are important risk factors that can predispose to lactation problems. The adequate management of those conditions is fundamental, as if not treated they frequently lead to early weaning. There are specific measures that should be taken to empty the breasts effectively. Besides, the emotional support and actions that yield more comfort to the lactating mother can not be neglected.

CONCLUSIONS

Most common problems associated with breastfeeding can be prevented if the mother empties her breasts effectively. If they occur, they should be carefully and adequately approached, thus avoiding the early weaning resultant from painful and stressing situations the mother may face.

Asphyxia due to pacifiers—case report and review of the literature

Pacifiers and bottle nipples entail the risk of asphyxia when they are swallowed, self-made or have become porous, or when used by older children whose teeth and chewing musculature have developed beyond the suckling stage. A further danger lies in the various devices used to tie the pacifier to the child, as they can cause strangulation. On the basis of this first case of a 2-year-old biting off a piece of her pacifier and fatally aspirating it, we point to the dangers and security requirements related to pacifiers and bottle nipples, and give a review of the related literature.

Pacifier use in children: a review of recent literature

Pediatric dentists are generally well aware of the oral implications of nonnutritive sucking (NNS). NNS via digit or pacifier can effect changes in the occlusion, including openbite, excessive overjet, and possibly posterior crossbite. Skeletal changes have also been attributed to NNS. There is some evidence that pacifiers may do less harm to the dentition, particularly because pacifier habits are often spontaneously shed at about 2 to 4 years of age. Digit habits are more likely to persist into the school-age years and can require appliance therapy for discontinuation. Thus, some authorities suggest that pacifiers be recommended for infants who engage in NNS. While pediatric dentists understand the oral and perioral effects of pacifiers, they may be less well versed in other aspects of pacifier use that have been reported in the medical, nursing, chemical, and psychological literature. This paper provides reviews of literature concerning the role of pacifier NNS in 4 areas: (1) sudden infant death syndrome; (2) breast-feeding; (3) otitis media and other infections; and (4) safety. Knowledge of current literature in these areas may assist pediatric dentists with their decisions of whether to recommend or discourage pacifier use in infants.

Impact of nasal airway obstruction on dentofacial development and sleep disturbances in children: preliminary notes

Respiratory disorders in the upper respiratory tract during sleep are most often part of a continuous pathological process of long standing. Schematically, three clinical syndromes with increasing severity are described: breathing with the mouth open, snoring and sleep apneal hypopnea syndrome. Obstructive sleep apnea syndrome (OSAS) is a subtle, but severe sleep disorder of early childhood. It is often difficult to detect and may have long-term consequences, including failure to thrive, behavioral disturbances, developmental delay, and cor pulmonale. These conditions always include a functional maxillofacial perturbation, which may be associated with a constitutional or acquired morphological disorder. Pediatric dentists must be aware of the problems connected with mouth breathing and OSAS (obstructive sleep apnea syndrome) in children as any delay in diagnosis and treatment may cause prolonged morbidity. They also have a role in the diagnosis and co-management of these patients because the signs and symptoms may be recognizable in the dental practice. Besides the medical approach itself, the treatment sometimes is surgical, always orthopedic: the earlier it is initiated, the more effective, simple and unrestraining it is. The aim of this work is to focus attention on the early diagnosis and prevention of these pathologies. Diagnostic guidelines will be illustrated.

Malocclusion associated with abnormal posture

Growth and development of maxillofacial morphology and oral function are closely interrelated. Oral function is comprised of articulation, swallowing, and chewing. Malocclusion may be caused by abnormal functions such as mouth breathing, tongue thrust swallowing, and unilateral chewing and by abnormal postures of oral circumferential muscles such as forward tongue thrust, tongue biting, and low tongue at rest. Forces from unintentional and habitual behaviors constantly acting on the maxillofacial and alveolar regions can cause the bony structures to generally deform, resulting in jaw deformity and malocclusion. Oral function also plays a vital role in maintaining body posture. In this study, clinical observations of oral postures examined maxillary protrusion and open bite, anterior crossbite and facial asymmetry. The unstable forces induced by abnormal posture were correlated with the varieties of malocclusion. Morphology, function, and posture were shown to be closely interrelated and to influence each other.

Randomized clinical trial of pacifier use and bottle-feeding or cupfeeding and their effect on breastfeeding

OBJECTIVE

To enhance breastfeeding practices, the World Health Organization discourages pacifiers and bottle-feeding. However, the effect of artificial nipples on breastfeeding duration is poorly defined. The effects of 2 types of artificial nipple exposure on breastfeeding duration were evaluated: 1) cupfeeding versus bottle-feeding for the provision of in-hospital supplements and 2) early (2-5 days) versus late (>4 weeks) pacifier introduction.

METHODS

A total of 700 breastfed newborns (36-42 weeks, birth weight >or=2200 g) were randomly assigned to 1 of 4 intervention groups: bottle/early pacifier (n = 169), bottle/late pacifier (n = 167), cup/early pacifier (n = 185), or cup/late pacifier (n = 179). The cup/bottle intervention was invoked for infants who received supplemental feedings: cup (n = 251), bottle (n = 230). Data were collected at delivery and at 2, 5, 10, 16, 24, 38, and 52 weeks' postpartum. Intervention effects on breastfeeding duration were evaluated with logistic regression and survival analyses.

RESULTS

Supplemental feedings, regardless of method (cup or bottle), had a detrimental effect on breastfeeding duration. There were no differences in cup versus bottle groups for breastfeeding duration. Effects were modified by the number of supplements; exclusive and full breastfeeding duration were prolonged in cup-fed infants given >2 supplements. Among infants delivered by cesarean, cupfeeding significantly prolonged exclusive, full, and overall breastfeeding duration. Exclusive breastfeeding at 4 weeks was less likely among infants exposed to pacifiers (early pacifier group; odds ratio: 1.5; 95% confidence interval: 1.0-2.0). Early, as compared with late, pacifier use shortened overall duration (adjusted hazard ratio: 1.22; 95% confidence interval: 1.03-1.44) but did not affect exclusive or full duration.

CONCLUSIONS

There was no advantage to cupfeeding for providing supplements to the general population of healthy breastfed infants, but it may have benefitted mother-infant dyads who required multiple supplements or were delivered by cesarean. Pacifier use in the neonatal period was detrimental to exclusive and overall breastfeeding. These findings support recommendations to avoid exposing breastfed infants to artificial nipples in the neonatal period.

Prevalence of malocclusion in 4-6 year old Brazilian children

The prevalence of malocclusion and the relationship with oral habits in Brazilian children from two public primary schools was evaluated. The sample was composed of 112 children with mean age of 61 +/- 6.67 months. The results demonstrated the presence of malocclusions in 75.8% (n = 85). The oral habits was related by 34.8% (n = 39). The open bite was the most prevalent malocclusion in the studied population and the oral habits was the decisive etiological factor.

Pacifier use and early childhood caries: an evidence-based study of the literature

This evidence-based study of the literature investigated the relationship between pacifier use (with and without sweetening and prolonged or short-term) and early childhood caries (ECC). The review was based on evidence from 3 main sources: a search of several electronic bibliographic databases, a review of the references from relevant studies for additional potentially relevant articles and a review of several dental textbooks. A total of 74 articles were reviewed. Of these, 8 were deemed relevant and were critically appraised according to a "causation checklist" of 13 items. The 8 studies assessed were methodologically inconsistent in terms of definitions of ECC, diagnostic criteria for identifying carious lesions, dental examination procedures, interviewing methods, and descriptions of pacifier use. None of the studies achieved a score greater than 6 and hence none was considered to present strong evidence. Six studies did not control for confounding variables, and the conclusions they generated were inconsistent. The evidence from the other 2 studies, which did control for confounding factors, presented slightly stronger evidence, but they indicated no statistical difference in pacifier use between children with and those without ECC; furthermore, the reported odds ratios suggested that pacifier use might have had a mildly protective effect. Overall, the evidence does not suggest a strong or consistent association between pacifier use and ECC.

Using pacifiers: what are breastfeeding mothers doing?

The objective of this study was to identify the impact of pacifier use on the duration of breastfeeding amongst Australian women. A cohort of 556 mothers who delivered in Perth, Western Australia was recruited to study their infant feeding practices. The mothers were interviewed in hospital and again at 2, 6, 10, 14, 18 and 24 weeks postpartum, or until they ceased to breastfeed. At two weeks 62% of breastfed babies were using a pacifier, increasing to a peak of 78% at six weeks. Infants who were using a pacifier had slightly fewer feeds each day at every age period (for example 6.9 versus 7.4 feeds at six weeks of age), but there was no difference in the number of night feeds. A recent study suggested that the mothers resorted to the use of pacifiers when they were having problems breastfeeding, and any impact of pacifiers on breastfeeding duration was due to confounding factors. However in this longitudinal study, after adjusting for the presence of breastfeeding problems, the use of a pacifier at two weeks was associated with reduced likelihood of breastfeeding to six months (odds ratio 0.40; 95%CI 0.25-0.63). Based on the results of this study we concluded that the use of a pacifier at two weeks of age reduced the likely duration of breastfeeding to six months. A possible mechanism of action was the reduced number of daily feeds in breastfed infants that would reduce breast stimulation. If mothers choose to use a pacifier they should introduce it later and use it infrequently.